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Prospective Comparison of Infective Endocarditis in Khon Kaen, Thailand and Rennes, France

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  • Global Disease Detection Center, Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes-1, Rennes, France; Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, Georgia; Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculte de Medicine, University of the Mediterranean, Marseille, France; Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, INSERM U835, Université Rennes-1, Rennes, France

Prospectively collected, contemporary data are lacking on how the features of infective endocarditis (IE) vary according to region. We, therefore, compared IE in Rennes, France and Khon Kaen, Thailand. Fifty-eight patients with confirmed IE were enrolled at each site during 2011 and 2012 using a common protocol. Compared with French patients, Thais had a lower median age (47 versus 70 years old; P < 0.001) and reported more animal contact (86% versus 21%; P < 0.001). There were more zoonotic infections among Thai than France patients (6 and 1 cases; P = 0.017) and fewer staphylococcal infections (4 versus 15 cases; P = 0.011). Underlying rheumatic heart disease was more prevalent in Thai than in French patients (31% and 4%; P = 0.001), whereas prosthetic heart valves were less prevalent (9% and 35%; P = 0.001). Our data strengthen previous observations that IE in the tropics has distinctive demographic characteristics, risk factors, and etiologies and underscore the need for improved prevention and control strategies.

Author Notes

* Address correspondence to George Watt, Global Disease Detection Center, Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand. E-mail: gwattth@yahoo.com

Financial support: This work was supported by the Global Disease Detection Program, the Division of Vector Borne Infectious Diseases at the Centers for Disease Control and Prevention, and the Mediterranee-Infection Foundation.

Authors' addresses: George Watt, Global Disease Detection Center, Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand, E-mail: gwattth@yahoo.com. Adele Lacroix, Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, Université Rennes-1, Rennes, France, E-mail: adele.lacroix@chu-rennes.fr. Orathai Pachirat, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, E-mail: orathai@hotmail.com. Henry C. Baggett, Global Disease Detection Center, Thailand Ministry of Public Health–US Centers for Disease Control and Prevention Collaboration, Nonthaburi, Thailand, and Division of Global Health Protection, US Centers for Disease Control and Prevention, Atlanta, GA, E-mail: Hfb8@cdc.gov. Didier Raoult and Pierre-Edouard Fournier, Unite de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Faculte de Medicine, University of the Mediterranean, Marseille, France, E-mails: Didier.Raoult@gmail.com and pierre-edouard.fournier@univ-amu.fr. Pierre Tattevin, Infectious Diseases and Intensive Care Unit, Pontchaillou University Hospital, INSERM U835, Université Rennes-1, Rennes, France, E-mail: pierre.tattevin@chu-rennes.fr.

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